11D2041441 CLIA NUMBER - LAKE HARTWELL DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2041441
  • Facility Name: LAKE HARTWELL DIALYSIS
  • Facility Address: 1065 E FRANKLIN STREET
    HARTWELL, GA
    ZIP 30643
  • Facility Phone: 706 376-3285
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. OMAR MUSHFIG
  • NPI Number: 1437417946
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2041441
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LAKE HARTWELL DIALYSIS
Street 1065 E FRANKLIN STREET
City HARTWELL
State GA
ZIP 30643
Phone 706 376-3285
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. OMAR MUSHFIG

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This page was last updated on: 9/29/2025